Journal of multidisciplinary healthcare
Par Zhao Y, Sun H, Huang W et 1 autres.
Contenu en anglais
This study evaluated the association between an integrated rehabilitation, airway-management, and nutritional nursing protocol and short-term outcomes in critically ill patients.
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This historical controlled before-after study included 101 adult ICU patients: 58 received conventional nursing and 43 received the integrated protocol. The primary outcome was pulmonary infection within 14 days or before ICU discharge, transfer, or death. Stabilized inverse probability of treatment weighting (IPTW), truncated at the 1st and 99th percentiles, was used to balance baseline covariates. Weighted risk differences (RDs), risk ratios (RRs), and mean differences (MDs) were estimated with robust variance.
After weighting, all baseline covariates had absolute standardized mean differences below 0.10. Pulmonary infection occurred in 14.1% of the intervention phase and 24.0% of the control phase after weighting (RD, -9.9 percentage points; 95% CI, -27.6 to 7.8; RR, 0.59; 95% CI, 0.21-1.66). The difference was not statistically significant. Exploratory analyses showed less gastrointestinal bleeding (RD, -16.0 percentage points; 95% CI, -25.1 to -6.9), higher SpO2 (MD, 2.09%; 95% CI, 0.99-3.19), shorter mechanical ventilation duration (MD, -4.57 days; 95% CI, -5.84 to -3.31), and shorter ICU stay (MD, -7.34 days; 95% CI, -9.11 to -5.57) during the intervention phase.
The integrated protocol was associated with favorable secondary outcomes, but the reduction in the primary outcome was not statistically significant. Larger prospective studies are required.
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